Organization
ONTARIO COMMONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE MARIE BRANCA (ACCOUNTS PAYABLE)
(419) 529-6447
Entity
Organization
Contact information
Practice address
2124 PARK AVE W, MANSFIELD, OH 44906-3807
(419) 529-6447
(419) 529-2108
Mailing address
2124 PARK AVE W, MANSFIELD, OH 44906-3807
(419) 529-6447
(419) 529-2108
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2165R
OH
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
Update your record
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